Our Research

Economic evaluation is a tool to assist and inform health care decision making. It considers both the resources required to provide health care interventions as well as the benefits provided by those interventions. They always consider at least two alternatives – one of which may be ‘do nothing’ or ‘status quo’. They are concerned with efficiency as they consider whether any additional benefits generated by an intervention compared to the next best alternative are worth any additional costs required to provide those benefits.

Economic evaluations to evaluate new health care interventions are an important component of our groups' research. This includes both economic evaluations conducted alongside clinical trials as well as decision-model based analyses.  We also have expertise in value of information analysis, a statistical technique to predict the return on investment from clinical trials to help prioritise future research.

This work is highly collaborative and we work closely with academic and clinical colleagues in a variety of disciplines. This includes links with individuals working in the National Health Service and other health care organisations, the University of East Anglia, and other national and international academic institutions. We also provide direct input into the East of England Research Design Service (EoE RDS). This provides health economics input into new research bids to ensure the quality of proposed economic evaluations are high. Several members of our team also work closely with the Norwich Clinical Trials Unit (NCTU). 

Health economics provides evidence to enable decision-makers to be more certain about the costs and benefits associated with particular health and social care services and interventions. Health economics “weighs up” the costs and benefits to ensure we obtain the best value from the resources we have, maximising the outcomes we attain for patients, the health system and society. But what outcomes do patients and the wider public want to achieve from our health and social care services and how much are they “worth”?

Our person-centred outcomes research informs evidence-based decisions. We focus on identifying, understanding and valuing outcomes that are most important for patients, their families, and the wider public. Outcomes we investigate include health-related quality of life and treatment burden. We use a mixed methods approach to outcome valuation. Deliberative methods such as the Citizens’ Jury or consensus group methods such as the Nominal Group Technique help us explore, prioritise and make recommendations about the outcomes that patients and the wider public think are most important. We use valuation methods such as the Discrete Choice Experiment, Best-Worst Scaling and “matching tasks” to elicit preferences for health and social care. We can use these preferences to explore risk:benefit trade-offs, derive quality of life weights and willingness to pay values for use in economic evaluation, and to quantify social value judgements that indicate the importance of equity as well as efficiency in health and social care. 

We have led a number of multidisciplinary projects in patient preferences and outcome valuation and have over a decades experience in this field.  Professor Jennifer Whitty is a founding member of the International Academy of Health Preference Research (IAHPR), which was established in order to improve decisions about health and healthcare by developing, promoting, and supporting health preference research.

Meeting the costs of disability and care needs in later life.

For many years, researchers within HEG have conducted research which aims to sharpen policy judgements on reform of care services funding and disability benefits for older disabled people, in the face of population ageing. Our work has focussed on how potential reforms to the current systems of disability benefits paid from the social security budget and state support for the costs of care, paid via Local Authorities, would be felt across income groups and other socio-economic categories. It applies econometric and microsimulation techniques to micro-data, typically from major household surveys, to understand the personal costs that disability brings in later life and to examine the distributional effects of potential reforms to disability benefits and social care funding for older people.

Much of our research has involved collaborations with, for example: the Personal Social Services Research Unit at the London School of Economics, the Institute for Social and Economic Research at Essex University, the Health Economics and Decision Science section of the School of Health and Related Research at Sheffield University and the Pensions Policy Institute.

Our track record of research and policy impact underpins our partnership in the ESRC Business and Local Government Data Research Centre. This is allowing us to use different forms of data to bring evidence on local variations in the impact of national policy on care and support for older people, to the continuing national and international policy debate on how to meet the costs of disability and care needs in later life.

Policy engagement and impact

Over the years, there have been various suggestions that public funds channelled through disability benefits for older people (Attendance Allowance (AA) and Disability Living Allowance (DLA)/Personal Independence Payment (PIP) should be redirected to the care system. The premise for these suggestions has often been that because disability benefits are not means tested, whereas subsidised social care is, the former are poorly targeted on those in most need. Our research has demonstrated that disability benefits for older people are in fact well targeted on those who can least afford the costs that disability brings in later life. These findings underpinned written evidence that we provided to a 2009/10 House of Commons Health Select Committee Inquiry into Social Care which was quoted widely in their report. The 2010 Social Care White Paper ruled out at least for the next Parliament, any reform of AA and DLA to fund its proposed reform of social care.

In 2016, the Government consulted on whether to devolve responsibility for AA to Local Authorities (“localisation of AA). A report we wrote as part of the Joseph Rowntree Foundation’s anti-poverty strategy, and a paper by the Strategic Society Centre which drew heavily on our research, were both quoted extensively in a House of Commons Library publication on the background to the consultation and to its final conclusion – in January 2017 the Secretary of State for Communities and Local Government announced that the Government would not be devolving AA to Local Authorities.

In December 2016 we published analysis of the distributional effects of saving money on state pensions by uprating them by less than the ‘triple lock’ and using some of the savings within the care and disability benefits system. During the 2017 election campaign, Theresa May indicated that she was considering less generous state pension uprating to release funds for social care.

More recently we submitted written evidence on long-term care funding options and on fairness and targeting of public support for older people with disabilities to a 2018 joint Inquiry by the Health & Social Care and Housing, Communities & Local Government committees into the long-term funding of adult social care.

Analysis of the effects of recently suggested reforms to the long-term care funding system can be found here.

We collaborate with fellow academics in a large number of UK, European, North American and Australasian institutions and work closely alongside the Norwich Clinical Trials Unit. Other external collaborators include:

• NIHR CLARHRC East of England
• RDS (East of England Research Design Service)
• Norfolk and Norwich University Hospitals NHS Trust
• Care Policy and Evaluation Centre at London School of Economics
• Institute for Social and Economic Research at Essex University
• National Heart and Lung Institute, Imperial College London
• Pensions Policy Institute
• Collaborative Network for Value of Information
• NHS Blood and Transfusion Clinical Trials Unit